Breast Cancer

A Look At The Pathology And Risk Factors Associated With This Common Disease

Breast tissue consists of different types of cells. These include adipocytes (fat cells), myoepithelial cells, ductus cells and lobule cells. Breast cancer is divided into different types depending on the cell from which it comes.

The most common type comes from the cells that make up the milk ducts. Not surprisingly, it's called "ductal carcinoma". The precancerous stage is referred to as "ductal carcinoma in situ" (DCIS). Ductal cells have cancerous features in DCIS, but have not yet "passed through" the tissue layer that separates ductal cells from other types of breast tissue. As soon as the cells become malignant enough, they can enter the basement membrane. At this point, it is considered cancer.

Cancer can also occur from the lobular units of the breast. In this case one speaks of "lobular carcinoma". It is a rarer form of carcinoma that makes up about 10% of all cases. An even rarer form is called inflammatory carcinoma; it accounts for less than 1% of cases.

Hereditary breast cancer is the exception rather than the rule. It is usually caused by mutations in the BRCA-1 or BRCA-2 genes. The protein products of these genes normally act as "tumor suppressors" by preventing abnormal cell replication. However, when these genes are mutated, they can no longer suppress abnormal replication and cancer can develop.

Known risk factors for the development of breast cancer are: mutations in BRCA-1 or 2, nulliparity, first pregnancy aged 35 years or older, menstruation before the age of 13, menopause after the age of 55, history of cancer, gender female (Men can also develop breast cancer!), Over 65 years of age and two or more parents with first degree breast cancer.

If a breast biopsy is performed that shows one of the following findings under the microscope, the risk of later developing breast cancer also increases: breast papilloma, ductal carcinoma in situ, lobular carcinoma in situ, sclerosing adenosis and atypical hyperplasia.

Interestingly, 70 to 75% of women have no known risk factor for developing breast cancer.

Popular breast cancer drugs can have serious side effects

Tamoxifen is a drug that interferes with the activity of estrogen, especially in the mammary glands of women. It has been used to treat and prevent breast cancer (CB) for 3 decades. Cells in British Columbia need estrogen to grow. Without estrogen, these cells are deprived of their vital nutrition and can die. This principle is used in the formulation of the drug tamoxifen. Tamoxifen binds to estrogen receptors in the breast and thus deprives breast cancer cells of vital proteins in estrogen. Imagine an auditorium with a limited number of seats and assume that the auditorium manager will inform all well-mannered people in advance and book their tickets. The auditorium is filled with all the good guys, the unruly bad guys who arrive too late have no place in the hall. The show in the auditorium takes place without any problems or unfortunate events. In this case, the good ones are the tamoxifen molecules that bind to the estrogen receptors, and the bad ones are the breast cancer cells. This process is also known as the competitive contrast.

Tamoxifen is only effective when the BC estrogen receptor is positive. It has no effect on breast cancer of the progesterone receptor and HER2 / neu (human epidermal growth factor 2 receptor) BC. But the good news is that almost 70% of all breast cancer cases are positive estrogen receptors and this drug can treat and even prevent breast cancer very effectively, well in advance.

However, there is a big problem and the use of this medicine is not without cost. No, it doesn't squeeze a lot into your wallet, even if insurance doesn't cover it in some cases. Tamoxifen has been withdrawn from the patent since 2002. It is now classified as a generic. Its price has dropped significantly since then. Although tamoxifen is very effective, it is not often prescribed as a preventive medication due to its chronic side effects. This drug is known to cause uterine or endometrial cancer in many women. The risk of developing this type of cancer increases fourfold even after two years of tamoxifen. The American Cancer Society has classified tamoxifen as a well-known carcinogen. Many women are known to use this medication to cause increased triglyceride levels and fatty liver syndrome. Needless to say, this is not good for the heart and liver.

Tamoxifen can have harmful effects on the central nervous system. It can severely affect perception and memory. Many patients who are prescribed this drug experience a sharp loss of libido and libido. As with any risky treatment, a cost-benefit analysis must be performed. Breast cancer is a serious and deadly disease. If tamoxifen is of great benefit to a single patient, it should be used. There are well-established preventive and mitigating treatments for the side effects caused by tamoxifen.